Background With a global focus on increased HIV testing among high risk groups including men who have sex with men (MSM), many community-based HIV testing services have been established in recent years with the goal of increasing testing opportunities for populations at risk. To better understand the acceptability of community based HIV testing models targeting MSM from the provider and consumer perspective we systematically reviewed published studies.
Methods We searched Medline, EMBASE and Cochrane databases from 1980 to October 2010. Studies were included if they described acceptability of community based HIV testing services targeting MSM, including outreach settings (eg, saunas, public events), collected through surveys, in-depth interviews, focus groups, or exit forms. A quantitative descriptive analysis of the barriers and facilitators of community based HIV testing identified by service providers and consumers was conducted.
Results We identified 25 papers that met our selection criteria and were included in the review see Abstract P5-S7.17 table 1. Twenty one studies focused on facilitators from the consumers' perspective, with testing convenience, provision of rapid testing, and acceptability/feeling comfortable with settings reported at factors that facilitated seeking HIV testing at community based services. From the provider perspective (six studies) key factors enhancing service acceptability were client friendly protocols, service promotion, offering additional clinical services, and effective protocols for follow-up and referral. Sixteen studies captured barriers to using community based HIV testing services from the consumer perspective and the main issue reported related to readiness to receive results on the same day or in the community-based environment. Providers in six studies reported difficulties in follow-up, testing in outreach settings, cost, providing adequate staff training, managing workload and developing and maintaining referral pathways as key barriers.
Conclusion Acceptability from both consumers and service providers is important to ensure an efficient and sustainable service. The experiences of many other services collated in this review will help other organisations address potential barriers and facilitators to the implementation of community-based HIV testing services.